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Pathology/Lab Coding Alert

CPT® 2015:
87505-87507: Check Out New GI Pathogen Detection Codes
Capture multiple targets with one code. If your lab performs one of the new commercial... Read more
CCI 20.3:
Overlook Semen Analysis Bundles at Your Peril
Choose just one code for most complete procedure. The last quarterly Correct Coding In... Read more
Medicare Rules:
Break the Modifier 59 Habit in 2015
Get more specific with 4 new X{EPSU}modifier options. If your lab or pathology practic... Read more
ICD-10:
Expect Direct Crosswalk for Procreative and Sterilization Testing
Primary diagnosis ban continues. Virtually nothing changes except the code numbers whe... Read more
Reader Question:
Choose Thin-Prep Pap Codes by Screening Technique
Question: I’m trying to select the proper code for the thin-prep Pap tests th... Read more
Reader Question:
Consider Modifier for Follow-Up Calcium
Question: Our lab performed a basic metabolic panel with total calcium, and the phy... Read more
Reader Question:
Sharing Private Health Information -- Know the Physician's Place
Question: Our pathologist wants to talk to an oncologist about a patient’s co... Read more
You Be the Coder:
Don't Wander from LCIS ICD-9 Choice
Question: The pathology report on a breast case states, “lobular carcinoma in... Read more
CPT® 2015:
Revamp Your IHC and ISH Reporting With 2015 'Makeover'
Look for parallel construction to simplify coding. After a year of dealing with contra... Read more
ICD-10:
Answer 'Where?' for Adenomatous Colon Polyps
You’ll need more info in 2015. When your pathologist diagnoses an adenomatous... Read more
Advance Beneficiary Notice:
Dispel 4 Lab ABN Myths With These Tips
Learn how to use the ‘courtesy’ modifier. Your lab often faces this hurdle... Read more
Medicare Incentives:
Avoid Pay Cuts with PQRS
Deadlines rush your lab clients to EHR, too. With more than enough pay cuts to go arou... Read more
Reader Question:
Distinguish Serologic Type and Screen
Question: If the lab performs a “type and screen” for a blood transfusi... Read more
Reader Question:
Zero In on Hip Fracture Exam Code
Question: A pathologist in our office believes that we can’t classify a hip f... Read more
You Be the Coder:
Metatarsal Amputation -- Foot or Toe?
Question: When our pathologist examines a transmetatarsal amputation specimen, do y... Read more
CPT® 2015:
Prepare for Nearly 90 New, Revised, or Deleted Lab Codes
You’ll need to learn yet another IHC-stain paradigm shift. Forewarned is forearm... Read more
ICD-10:
187.8 Scatters in Diagnosis Code-Set Transition
Distinguish penis, other male genital organs for overlapping sites. You won’t fi... Read more
Clip and Save:
Get Familiar With CPT® 2015 Lab and Pathology Code Changes
Save this handy chart for future reference throughout the coming year. An overview can... Read more
Compliance:
Follow 3 Tips to Seize Opportunities and Face Demands for Your Lab
Stick with HIPAA, CLIA, HITECH direction. It’s a wonder that anyone can keep up ... Read more
Reader Question:
Method, CLIA Rules Lead Code Choice
Question: Our lab performs urine drug testing by dipstick for multiple drugs as par... Read more
Reader Question:
88305 Encompasses Biopsy
Question: If the pathologist receives a specimen labeled “breast excisional b... Read more
Reader Question:
Meet Qualifications for Specific Codes
Question: Our lab has a gynecologist client who is trying to charge 88141 for inter... Read more
You Be the Coder:
Check These Diagnoses for Pathologic Femur Fracture
Question: Our pathologist examined a femur neck specimen with a fracture from the p... Read more
CCI 20.2:
Beware IHC Bundles for Medicare
Recap CCI Policy Manual explanations. Unlike in some past years, you won’t get o... Read more
ICD-10:
Order HER2/neu For Breast Cancer With This Code
Learn crosswalk from ICD-9. Sometimes your pathologist gets a request for HER2/neu imm... Read more
CPT® 2015:
Expect Drug Testing Overhaul Next Year
Learn presumptive and definitive categories. If you’re like many lab coders who ... Read more
Cytology:
Follow 3 Tips to Capture Repeat Pap Test Pay
Reason for repeat is key. Coding for Pap tests is complicated enough, but coding for r... Read more
Reader Question:
Code Final Diagnosis
Question: We received an excision specimen labeled “left thumb mass.” T... Read more
Reader Question:
Select Glucose Code by Method
Question: We’re getting denials when we bill a blood glucose test with 82962.... Read more
Reader Question:
Look for Pathologic Fracture Detail in ICD-10
Question: When the pathologist diagnoses a pathologic fracture in the femur seconda... Read more
You Be the Coder:
Don't Let 'Container' Fool You
Question: The pathologist received a single specimen container with tissue identifi... Read more
Case Study:
Don't Lose $218 for This Prolapsed Uterus With Fibroids
Use final diagnosis to snag additional pay. You may think that coding the pathology ex... Read more
Compliance:
See How Your Hospital Lab Can Bill TC for Non-Hospital Patients
You can choose who bills the payer. Question: When is a hospital lab an independent la... Read more
ICD-10:
Learn D25 Vocabulary to Broaden Uterine Fibroid Dx
Look for a direct crosswalk with more specific descriptions. You won’t have b... Read more
Lab Modifiers:
Make Payer Rules Your Bottom Line for 59, 91, 76, and More
Don’t rely on definitions alone. You can parse the CPT® modifier descriptors... Read more
Reader Question:
Follow Payer for Drug Test Code Choice
Question: The lab performs a drug screen using a cup method, then performs a confir... Read more
Reader Question:
Don't Use 88342 for All Negative HER-2/neu
Question: Our lab performs a HER-2/neu antibody test on paraffin embedded breast ti... Read more
Reader Question:
Show the Secondary Diagnosis for Hepatitis Screen
Question: A physician client requested a hepatitis screening test for a patient wit... Read more
You Be the Coder:
Count Specimens for Medicare Prostate Biopsy Codes
Question: The pathologist received and examined six prostate biopsy specimens. Shou... Read more
Microbiology:
Dominate Infectious Agent Antigen Coding With These 5 Tips
Reporting 87260-87902 just got easier. Only a couple of small changes infected the CPT... Read more
CPT® 2014:
1 Code + 1 Phrase = Microbiology Changes You Need to Know
Reverse transcription not required. Now that you’ve refreshed your memory on how... Read more
ICD-10:
Hierarchy Scrambles Hepatitis C Codes
Acute/chronic distinction will lead in ICD-10. You’ll have the same number of co... Read more
Surgical Pathology:
Know When to 'Unbundle' Thyroidectomy
Don’t lose $71 that your pathologist deserves. Here’s something that doesn... Read more
ICD-10 Implementation:
Check Out This CMS Update
ICD-9 update in question, too. You might have more questions than answers about the IC... Read more
Reader Question:
Avoid 'Insufficient' Diagnosis Terminology
Question: For an FNA evaluation, the pathologist wrote a final diagnosis of “... Read more
Reader Question:
Check 3 Rs for Interpretation
Question: When our lab performs a serum protein electhrophoresis and quantifies the... Read more
Reader Question:
Distinguish Wet Mount, Other Vaginal Tests
Question: The lab receives a vaginal fluid specimen for an “amines” tes... Read more
Reader Question:
Immunohistochemistry Depends on Method
Question: The lab report states, “progesterone receptor negative: 0 staining ... Read more
You Be the Coder:
Choose FISH as PhD or MD Service
Question: If we perform FISH aneuploidy +13, +18, +21, X, Y for a paraffin-embedded... Read more
Case Study:
Hone Your Bone Coding With This Report
88304-88309 hold the keys. Selecting a surgical pathology code might seem straightforw... Read more
Cytopathology:
88160-88162: Finally Master These Niche Specimen Codes
Avoid the 5-slide trap. Here’s a code that baffles many new pathology coders, an... Read more
Diagnosis Update:
733.11 Crosswalks to 85 Code Choices in ICD-10
Remember 7th digit for encounter. How much more can you say about a disease-related... Read more
Protecting Access to Medicare Act of 2014:
Watch the New Direction that CLFS Repricing Takes
Law impact on labs is more than ICD-10 delay. You’ve heard the frenzy over the I... Read more
Reader Question:
Master HCPIN in ICD-9, ICD-10
Question: I find prostate diagnoses very confusing, with PIN III and CIS and other ... Read more
Reader Question:
Do This for Repeat Lab Test
Question: A physician ordered an electrolyte panel for a 72-year-old female patient... Read more
Reader Question:
Zero In on Coombs Test for Obstetric Panel
Question: We perform the obstetrics panel except that we perform an indirect Coombs... Read more
Reader Question:
Capture Separate Ovarian Pathology
Question: Our pathologist received a uterus/tubes/ovaries specimen in which he diag... Read more
You Be the Coder:
Method, Payer, CLIA Rules Lead Code Choice
Question: Our lab performs urine drug testing by dipstick for multiple drugs as par... Read more
Morphometric Analysis:
Avoid 5 IHC Pitfalls and Get Home by 6
Counting and computers are key. Don’t spend all day trying to get your quantitat... Read more
88360-88361:
Sidestep CCI Edits for Smooth IHC Sailing
Watch for common bundles you need to know. Now that you’ve learned how to &ldquo... Read more
ICD-10:
Straddle Lymphoid Cancer Classification
Don’t let name changes confuse you You’ll have a direct crosswalk for B-ce... Read more
Breast Case:
To Bundle or Not to Bundle: That is the $288 Question
Focus on specimen to make the ‘margin’ call. Everyone’s scared of &l... Read more
Implementation Delay:
You Have At Least 1 More Year for ICD-10 Prep
Don’t fall into theprocrastination trap. “The Secretary of Health and Huma... Read more
News You Can Use:
Medicare Pay Cut Averted
Payment stays level through March 31, 2015. Remember the threat of a drastic pay cut f... Read more
Reader Questions:
Make Sure Stain is 'Special'
Question: Our pathologist went to the surgical suite and performed an FNA adequacy ... Read more
Reader Question:
Block Versus Specimen for ISH
Question: We run HPV sub-typing for high-risk and low-risk strains on two blocks fr... Read more
You Be the Coder:
Distinguish Vaginal Tissue Codes
Question: Our pathologist examined tissue from a vaginal mesh removal and reported ... Read more
Pap Testing:
Hone Your Skills With This Screening-Turned-Diagnostic Pap Case
Don’t miss HPV opportunity. With 15 CPT® codes and 10 HPCS Level II codes fo... Read more
ICD-10:
Look for HPV Changes on October 1
Low risk gets its own code. When your lab reports positive results for human papilloma... Read more
Clinical Lab Tests:
Thought You Could Never Charge for Calculations? Think Again
Just be careful not to double bill. You’ve heard it said that you can never bill... Read more
For the Record:
7 Characteristics Embody Good Documentation
Make sure your pathologist has the tools. Your coding skills might be top notch, but y... Read more
Reader Question:
Focus on Transplant Suitability
Question: How should we code if we perform HLA typing for multiple A and B antigens for ... Read more
Reader Question:
Don't Lose UA Pay
Question: If we do a urinalysis (UA) dipstick test in the office lab and find an abnorma... Read more
Reader Question:
Beware Skin Upcoding
Question: Our pathologist examined a large (13 cm x 6 cm) skin excision from a patient&r... Read more
Reader Question:
Distinguish NOS, NEC
Question: What is the difference between NEC and NOS in the ICD-9 manual, and will I nee... Read more
You Be the Coder:
Check FOBT Coverage Rules
Question: We’re receiving denials for three-card fecal hemoccult screening tests t... Read more
CCI 20.0:
Don't Double Dip with 'Method' Codes
Molecular pathology includes every step. Each January, you can expect new Correct Coding ... Read more
Medicare Payment:
G0461, G0462 Capture Qualitative IHC
Distinguish rules for 88342, +88343. The CPT® 2014 promise of billing immunohistoc... Read more
ICD-10:
Z17.0-Z17.1 Mirror ER Status Reporting
Expect direct crosswalk with new code set. Only the numbers and letters will change fo... Read more
Quantitative/Semiquantitative IHC:
88360-88361 Use 'Specimen' as Unit of Service
Only 88342 allows ‘per block.’ Problem: The same immunohistochemistry (IHC... Read more
Medicare Payments:
Get Answers to CF, SGR, Sequestration Pay Questions
Define your 2014 pathology pay expectations. CMS settled several payment questions as ... Read more
Reader Question:
Check CLIA List for Waived Tests
Question: If we’re performing 85610 and 80061 in a physician-office lab, should we... Read more
Reader Question:
Simple Collection Included
Question: Is there a CPT® code for swabbing a wound to collect fluid to send to a la... Read more
Reader Question:
Don't Use 52 for Lab Equipment Failure
Question: We’ve always reported Pap tests to one payer with 88174, but now they&rs... Read more
Reader Question:
88104 Describes Abscess Drainage Exam
Question: We received drainage from a lymph node abscess. The pathologist examined a dir... Read more
You Be the Coder:
Capture Consult and Special Stains
Question: When we receive a tissue block for consultation and prepare additional H&E... Read more
MPFS 2014:
20.1 Percent Cut Awaits Act of Congress
Proposal for cap at OPPS levels tabled — for now. Your anatomic pathology practi... Read more
G0416:
Prepare to Change Your Prostate Biopsy Exam Coding
Surprise definition change in MPFS could cost your practice plenty. Out of the blue, t... Read more
ICD-10 Preparedness:
Get Ready to Test Your Lab
Mark your calendars for March testing week. Maybe you’ve done your preparation a... Read more
CLFS 2014:
Watch Out for 'Revaluation' and 'Bundling'
Payment levels net little change. Pricing isn’t the only thing you need to look ... Read more
Reader Question:
Appeal, Don't Resend, Denied Claims
Question: If we know that the Medicare contractor has made a mistake in denying one of o... Read more
Reader Question:
Revert to Ordering Diagnosis
Question: Our pathologist recently examined a prostate biopsy specimen for a patient who... Read more
Reader Question:
Clarification: See Who Can Bill for Arterial Puncture
Question: I read in your newsletter Vol. 14 No. 11 “Don’t Confuse Blood Draw... Read more
Reader Question:
Bill Culture Despite no Growth
Question: We are performing a cytogenetic analysis on a bone marrow specimen, and after ... Read more
Reader Question:
Pick Specific Organism Code
Question: We can’t find a “not otherwise specified” code for infectiou... Read more
You Be the Coder:
Neoplasm Drives Ovary/Tube Specimen
Question: What is the correct procedure code for right salpingo-oophorectomy with a diag... Read more
CPT® 2014:
81057, 87661: These Codes May Have Ob/Gyn Clients Calling
Fetal evaluations and STD infection diagnosis at stake. You might see more lab test or... Read more
ICD-10:
Trichomoniasis Boasts Direct Crosswalk
Organism and infection site focus codes. Coding urogenital Trichomonas infections won&... Read more
CPT® 2014:
10 Reasons to Update Therapeutic Drug Assay Codes
See what you can expect for payment, too. When physicians order quantitative assays fo... Read more
Modifier Update:
Avoid Pitfalls of 59 Overuse
Look to 91 or 76 in some cases. Rumor has it that Medicare no longer accepts modifier ... Read more
Reader Question:
Distinguish Surgery from Pathology Procedure
Question:Our pathologist examined a “shave biopsy,” and when I spoke to the ... Read more
Reader Question:
Modifier PT is Out for Pathology
Question: We billed 88305 and 88342 with modifier PT for a diagnosis of V76.51 and 211.3... Read more
Reader Question:
Whooping Cough Test Code is in the Details
Question: Due to increased number of whooping cough cases, we’re starting to perfo... Read more
Reader Question:
Distinguish Cyst, Neoplasm
Question: What are the correct diagnosis and procedure codes for a hair follicle excisio... Read more
You Be the Coder:
Capture Polarizing Microscopy Service
Question: The pathologist examined a bursa fluid aspirate smear from the left elbow, ide... Read more